Each year, tens of millions of Americans take statins in order to lower their cholesterol. Statins prevent your body from producing cholesterol. They may also help your body to reduce the plaque or buildup from cholesterol inside your arteries. Plaque that remains in your arteries may eventually partially or fully clog your arteries. This can lead to a heart attack or stroke.
Who Needs Statins?
Not everyone with high cholesterol will need to be treated with statin medication. The single greatest determining factor is your cholesterol level.
|Know Your Numbers: What Does Healthy Cholesterol Look Like?|
|Total cholesterol level||Below 200 mg/dL|
|LDL (bad) cholesterol||Below 100 mg/dL|
If you are at risk for any cardiovascular diseases or have a history of heart attack or heart problems, you may be a better candidate than a person who doesn’t have as many pre-existing conditions or potential complicating factors.
Beyond those simple principles, the American College of Cardiology and American Heart Association have identified four groups of people who should consider taking statins. They include:
- people who have been diagnosed with cardiovascular disease
- people who have high levels of LDL (greater than 190 mg/dL)
- diabetics between the ages of 40 and 75 who have elevated LDL levels (70 to 189 mg/dL) but have not yet been diagnosed with cardiovascular disease
- people with an elevated LDL level (over 100 mg/dL) and an increased risk of developing cardiovascular disease or having a heart attack in the next 10 years
Statins and Fatigue
The use of statins isn’t without its controversies or issues. In recent years, researchers discovered that patients taking statins reported increased levels of general fatigue and tiredness, especially after exertion.
In fact, a study from the University of California, San Diego found that people taking statins experienced lower levels of energy than people who took a placebo. These side effects increased as the dosage of the statin increased, and the levels of statins used in that study were relatively low. It’s not uncommon for doctors to prescribe higher doses than what was studied.
Women are at particular risk. The same study from UCSD found that 4 in 10 women experienced fatigue and loss of energy after activity. Also, people between the ages of 70 and 75, especially if they had been diagnosed with heart disease, were more likely to experience these side effects.
Why does this occur? Unfortunately, that remains unclear.
Fatigue isn’t the only unwanted symptom related to the use of statins. Before you begin taking the medication, consider these additional side effects.
The most common side effect of statins is digestive problems. Diarrhea, nausea, gas, and heartburn are not uncommon problems associated with the use of statins. These may improve after a few weeks of treatment.
Muscle Pain and Damage
You could experience muscle pain when taking a statin. You may begin experiencing soreness, tiredness, or even weakness in your muscles. The pain may be mild, or it may become severe enough to greatly impact your daily routine. If you have any new or unusual muscle pain or fatigue after starting a statin, talk to your doctor right away. Ignoring muscle pain can make it worse. There is also a risk that the pain can progress to serious muscle damage called rhabdomyolysis.
This life-threatening type of muscle damage is very rare. In addition to pain, people who develop rhabdomyolysis may experience darkened urine, reduced kidney function, and even kidney failure. It can progress to liver damage, and ultimately death.
Using statins may cause your liver to produce more enzymes than needed. If the levels are low, you may be okay to continue taking statins. If they are too high, you may need to stop. To check your liver enzyme levels, your doctor will order a blood test soon after you begin taking the medication.
Rash or Flushing
You may develop a skin rash or flushing after you begin taking statins. Talk with your doctor about ways to prevent this.
Increased Risk for Type 2 Diabetes
Some people taking a statin will develop increased blood sugar levels. This may lead to the development of type 2 diabetes if not managed properly. If you are at risk for diabetes, your doctor may check your blood sugar a few weeks after you start the drug.
Memory Loss or Confusion
Neurological side effects from statin use are uncommon, but not unheard of. Stopping the use of statin medications typically reverses memory problems.
Talk with Your Doctor
If your doctor suggests that you may benefit from the use of statins to control your cholesterol or to reduce your risk of heart attack, have a discussion. By now, your doctor should be aware of the potential fatigue and energy issues related to the use of statins. If these side effects are of concern to you or may interfere with your lifestyle, discuss alternatives or solutions to the fatigue you might experience.
Request the lowest dose to test possible side effects first. Ask about lifestyle changes that might reduce your need for statins. If you maximize your effort to improve your diet and exercise, you may need less treatment for cholesterol. Lastly, don’t be afraid to get a second opinion about the use of statins and any alternative measures you can take to reduce your need for the cholesterol-lowering medicines. Ultimately, living a healthier life can drive down your risk for high cholesterol and cardiovascular disease. You and your doctor can work to find a balance that is right and healthy for you.